Q. I have urticaria for a long time. Will steroids alleviate my symptoms? Please help.

Hello doctor,

I am a 78 years old male. I have urticaria (hives) for a long time. I have been to local dermatologists many a time in the past few years. I have been taking one tablet of Allegra 180 daily for the past year. I have used and still using many creams, such as Evion, Flucort, vitamin E ointment, and many others intermittently over the past many years. I am not seeking a cure for my problem because I know it cannot be cured entirely, but it has to be managed.

In the last few weeks, I have developed a peculiar problem. When I am awake, I avoid scratching the itching skin. When I go to sleep at night, I wear knee-length socks, a long-sleeved shirt, and cotton gloves. However, while asleep, I scratch despite wearing those coverings because I push the cloth coverings aside without realizing it. When the pain from scratching reaches a level to wake me up, I will start applying moisturizer and rearrange the coverings. After a few minutes, I go back to sleep. Some nights, I will not get up again in the night, and sometimes I will get up the second time and go through the whole rigmarole.

Because of COVID-19, my sons have locked me down in my room without allowing me to go out of the house. To while away time, I am surfing the internet for a few hours every day. In one of the sites, I read that a limited time-bound usage of steroid ‘Prednisone’ may alleviate the itch. I then remembered a health incident that happened to me more than eight years back. I developed a continuous dry cough for days. I then consulted ENT specialist. She prescribed many a test, including a chest CT scan. She then prescribed Prednisone. It was a five-day regimen. For the first two days, I was prescribed a certain dosage of tablets. For the next two days, my dosage per day was halved. On the fifth day, I took only one pill. Believe it or not, my cough vanished.

I remember that my elders used to call that cough as a dog’s cough.

My query is, whether Prednisone or any other similar steroid will alleviate symptoms of my urticaria. If it can, will you please prescribe me the regimen of such medication. How many days need I take the tablets? Should I take 5 mg, 10 mg, or any other? If you cannot ethically prescribe steroids without examining me, it is fine to disregard my request.